The Association between Door-to-Balloon Time of Less Than 60 Minutes and Prognosis of Patients Developing ST Segment Elevation Myocardial Infarction and Undergoing Primary Percutaneous Coronary Intervention

被引:17
作者
Chen, Fu-Cheng [1 ]
Lin, Yan-Ren [2 ,3 ,4 ]
Kung, Chia-Te [1 ]
Cheng, Cheng-I [5 ]
Li, Chao-Jui [1 ]
机构
[1] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Dept Emergency Med, Coll Med, Kaohsiung, Taiwan
[2] Changhua Christian Hosp, Dept Emergency Med, Changhua, Taiwan
[3] Kaohsiung Med Univ, Sch Med, Kaohsiung, Taiwan
[4] Chung Shan Med Univ, Sch Med, Taichung, Taiwan
[5] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Div Cardiol, Dept Internal Med,Coll Med, Kaohsiung, Taiwan
关键词
MORTALITY; DELAY; REPERFUSION; PREDICTORS; GUIDELINES; SYSTEM; IMPACT;
D O I
10.1155/2017/1910934
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Background. The study aimed to verify the effect of primary percutaneous coronary intervention (PPCI) with < 60 min door-toballoon time on ST segment elevationmyocardial infarction (STEMI) patients' prognoses. Methods. Outcomes of patients receiving PPCI with door-to-balloon time of < 60 min were compared with those of patients receiving PPCI with door-to-balloon time 60-90 min. Result. Totally, 241 STEMI patients (191 with Killip classes I or II) and 104 (71 with Killip classes I or II) received PPCI with door-to-balloon time < 60 and 60-90 min, respectively. Killip classes I and II patients with door-to-balloon time < 60 min had better thrombolysis inmyocardial infarction (TIMI) flow(9.2% fewer patientswith TIMI flow< 3, p = 0.019) and 8.0% lower 30-day mortality rate (p < 0.001) than those with 60-90 min. After controlling the confounding factors with logistic regression, patients with door-to-balloon time < 60 min had lower incidences of TIMI flow < 3 (aOR = 0.4, 95% CI = 0.20-0.76), 30-day recurrent myocardial infarction (aOR = 0.3, 95% CI = 0.10-0.91), and 30-day mortality (aOR = 0.3, 95% CI = 0.09-0.77) than those with 60-90 min. Conclusion. Door-to-balloon time < 60 min is associated with better blood flow in the infarct-related artery and lower 30-day recurrent myocardial infarction and 30-day mortality rates.
引用
收藏
页数:6
相关论文
共 23 条
[1]   Predictors of door-to-balloon delay in primary angioplasty [J].
Angeja, BG ;
Gibson, CM ;
Chin, R ;
Frederick, PD ;
Every, NR ;
Ross, AM ;
Stone, GW ;
Barron, HV .
AMERICAN JOURNAL OF CARDIOLOGY, 2002, 89 (10) :1156-1161
[2]   Temporal changes in emergency department triage of patients with acute myocardial infarction and the effect on outcomes [J].
Atzema, Clare L. ;
Schull, Michael J. ;
Austin, Peter C. ;
Tu, Jack V. .
AMERICAN HEART JOURNAL, 2011, 162 (03) :451-459
[3]   Emergency Department Triage of Acute Myocardial Infarction Patients and the Effect on Outcomes [J].
Atzema, Clare L. ;
Austin, Peter C. ;
Tu, Jack V. ;
Schull, Michael J. .
ANNALS OF EMERGENCY MEDICINE, 2009, 53 (06) :736-745
[4]   Strategies for reducing the door-to-balloon time in acute myocardial infarction [J].
Bradley, Elizabeth H. ;
Herrin, Jeph ;
Wang, Yongfei ;
Barton, Barbara A. ;
Webster, Tashonna R. ;
Mattera, Jennifer A. ;
Roumanis, Sarah A. ;
Curtis, Jeptha P. ;
Nallamothu, Brahmajee K. ;
Magid, David J. ;
McNamara, Robert L. ;
Parkosewich, Janet ;
Loeb, Jerod M. ;
Krumholz, Harlan M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (22) :2308-2320
[5]   Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group - Insights from the Global Registry of Acute Coronary Events [J].
Brieger, D ;
Eagle, KA ;
Goodman, SG ;
Steg, PG ;
Budaj, A ;
White, K ;
Montalescot, G .
CHEST, 2004, 126 (02) :461-469
[6]   Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain [J].
Canto, JG ;
Shlipak, MG ;
Rogers, WJ ;
Malmgren, JA ;
Frederick, PD ;
Lambrew, CT ;
Ornato, JP ;
Barron, HV ;
Kiefe, CI .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 283 (24) :3223-3229
[7]   Improving Door-to-balloon Time by Decreasing Door-to-ECG time for Walk-in STEMI Patients [J].
Coyne, Christopher J. ;
Testa, Nicholas ;
Desai, Shoma ;
Lagrone, Joy ;
Chang, Roger ;
Zheng, Ling ;
Kim, Hyung .
WESTERN JOURNAL OF EMERGENCY MEDICINE, 2015, 16 (01) :184-189
[8]   Trends in Door-to-Balloon Time and Mortality in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention [J].
Flynn, Anneliese ;
Moscucci, Mauro ;
Share, David ;
Smith, Dean ;
LaLonde, Thomas ;
Changezi, Hameem ;
Riba, Arthur ;
Gurm, Hitinder S. .
ARCHIVES OF INTERNAL MEDICINE, 2010, 170 (20) :1842-1849
[9]   Minimizing Door-to-Balloon Time Is Not the Most Critical Factor in Improving Clinical Outcome of ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention [J].
Ho, Yuan-Chih ;
Tsai, Tzu-Hsien ;
Sung, Pei-Hsun ;
Chen, Yung-Lung ;
Chung, Sheng-Ying ;
Yang, Cheng-Hsu ;
Chen, Shyh-Ming ;
Chen, Chien-Jen ;
Fang, Hsiu-Yu ;
Wu, Chiung-Jen ;
Yip, Hon-Kan .
CRITICAL CARE MEDICINE, 2014, 42 (08) :1788-1796
[10]   Implementation of a statewide system for coronary reperfusion for ST-segment elevation myocardial infarction [J].
Jollis, James G. ;
Roettig, Mayme L. ;
Aluko, Akinyele O. ;
Anstrom, Kevin J. ;
Applegate, Robert J. ;
Babb, Joseph D. ;
Berger, Peter B. ;
Bohle, David J. ;
Fletcher, Sidney M. ;
Garvey, J. Lee ;
Hathaway, William R. ;
Hoekstra, James W. ;
Kelly, Robert V. ;
Maddox, William T., Jr. ;
Shiber, Joseph R. ;
Valeri, F. Scott ;
Watling, Bradley A. ;
Wilson, B. Hadley ;
Granger, Christopher B. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 298 (20) :2371-2380